Certified nursing homes that take Medicare or Medicaid payment have to meet the requirements in 42 CFR Part 483, Subpart B. Those rules cover resident rights, freedom from abuse, care planning, quality of care, nursing services, infection prevention, and the rest of daily life in the building. CMS tells state survey agencies how to apply the rules in Appendix PP of the State Operations Manual. Appendix PP is organized by tag. The tag is the label on the citation. The regulation is the requirement.
The Nursing Home Data Dictionary describes each health citation as one row: a certification number, a survey date, a one-letter prefix, a tag number, a short description, a scope and severity code, a correction status, and flags for the kind of survey. In the health file the prefix is F. Fire-safety findings use K. Emergency-preparedness findings use E. Those series are in other files. The glossary on this site is built from the F-tags, and any older tag numbers, that actually appear in the current Health Deficiencies file.
The tag names the requirement
A tag number does not say whether one person or the whole building was affected, and it does not say whether anyone was hurt. F689 with a D and F689 with a J are the same requirement and different findings. The number points at the rule. The letter, which the next section covers, is the surveyor's judgment of scope and harm on that survey date.
CMS groups tags into categories such as resident assessment and care planning, quality of life and care, and infection control. The category is a filing label for Care Compare and for the column in the deficiencies file. It is useful when you are scanning a long survey. It is not a separate score. On this site the glossary is sorted by those categories, and each tag page repeats the description that shows up most often for that code in this release, plus the number of citation rows and the number of homes.
Surveyors can cite more than one tag from the same visit. A fall may lead them to the accident tag and also to the care-plan tag, if the plan never addressed the risk they found. A citation is the finding for the date on the row. The file also has a correction status and, when CMS has one, a correction date. A corrected status is CMS's statement about that citation. It is still worth asking the home what changed, because the row does not describe the new routine in plain language.
Scope and severity, A through L
CMS scores every citation on two axes. Scope is isolated, pattern, or widespread. The harm level runs from a potential for minimal harm, through a potential for more than minimal harm, to actual harm, and then to immediate jeopardy. The twelve letters are the combinations. Immediate jeopardy is J, K, or L. Actual harm that is not immediate jeopardy is G, H, or I. Letters A, B, and C are findings with the potential for no more than minimal harm. In Table 1 of the September 2026 Technical Users' Guide, A, B, and C contribute zero points to the health inspection score. Higher letters contribute more points. Some cells add further points when the deficiency is substandard quality of care. If a deficiency is past non-compliance and the severity was immediate jeopardy, the guide assigns the points used for a G-level deficiency.
| Letter | Scope | Harm |
|---|---|---|
| A | Isolated | No actual harm, with potential for minimal harm |
| B | Pattern | No actual harm, with potential for minimal harm |
| C | Widespread | No actual harm, with potential for minimal harm |
| D | Isolated | No actual harm, with potential for more than minimal harm |
| E | Pattern | No actual harm, with potential for more than minimal harm |
| F | Widespread | No actual harm, with potential for more than minimal harm |
| G | Isolated | Actual harm that is not immediate jeopardy |
| H | Pattern | Actual harm that is not immediate jeopardy |
| I | Widespread | Actual harm that is not immediate jeopardy |
| J | Isolated | Immediate jeopardy to resident health or safety |
| K | Pattern | Immediate jeopardy to resident health or safety |
| L | Widespread | Immediate jeopardy to resident health or safety |
Read the letter before you treat two citations as the same kind of event. An isolated finding with no actual harm is a D. The same requirement, cited as widespread and as immediate jeopardy, is an L. The star-rating guide explains how those points, revisit points, and the age of the survey become the health inspection rating. Citations that are still in informal dispute resolution or independent informal dispute resolution stay on the public record and stay out of the star calculation until the dispute ends.
Four tags families ask about
Thousands of tag numbers exist in Appendix PP. Four of them come up often when families read a record: accidents, abuse and neglect, infection prevention, and the care plan. The sentences below follow the regulation and the surveyor guidance. Where this release has rows, the count is the number of citation rows in the Health Deficiencies file, so one home can contribute more than one.
F689, accident hazards and supervision
F689 is the tag for 42 CFR 483.25(d). The facility must keep the resident environment as free of accident hazards as is possible, and each resident must receive adequate supervision and assistance devices to prevent accidents. Appendix PP tells surveyors that an accident is an unexpected or unintentional incident that results or may result in injury or illness. A fall, a missing resident, a burn, or an unsafe wheelchair can land here. The guidance also says that not every accident is avoidable. Surveyors look at whether the home identified the hazard, put interventions in place, and watched whether those interventions worked. In this file, the description CMS uses most often for F689 is “Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.” The code appears on 21,343 citation rows at 10,076 homes.
F600, abuse and neglect
F600 is the tag for the opening of 42 CFR 483.12. The resident has the right to be free from abuse, neglect, misappropriation of property, and exploitation. The definitions sit in 42 CFR 483.5. Abuse is the willful infliction of injury, unreasonable confinement, intimidation, or punishment with resulting physical harm, pain, or mental anguish. Willful means the act was deliberate. It does not mean the person set out to cause the injury. Neglect is the failure of the facility, its employees, or its service providers to provide goods and services a resident needs in order to avoid physical harm, pain, mental anguish, or emotional distress. In this file, the description CMS uses most often for F600 is “Protect each resident from all types of abuse such as physical, mental, sexual abuse, physical punishment, and neglect by anybody.” The code appears on 8,701 citation rows at 5,088 homes.
Appendix PP points misappropriation and exploitation to F602, and involuntary seclusion to F603. The September 2026 star-rating guide uses F600, F602, and F603 when it turns on the abuse icon. A citation at one of those tags is a survey finding. The icon is a separate flag with its own rules, described in the star-rating guide. A family that sees F600 should read the severity letter and the survey date, then ask the home and the state survey agency what was found and what was reported.
F880, infection prevention and control
F880 is the tag for 42 CFR 483.80. The facility must establish and maintain an infection prevention and control program designed to provide a safe, sanitary, and comfortable environment and to help prevent the development and transmission of communicable diseases and infections. The program includes a system for preventing, identifying, reporting, investigating, and controlling infections and communicable diseases. Surveyors cite F880 when that program is missing, out of date, or not followed. Hand hygiene, isolation practice, linen, and water management can all be part of the review. The tag is the program requirement. A single sick resident is not, by itself, the citation. In this file, the description CMS uses most often for F880 is “Provide and implement an infection prevention and control program.” The code appears on 24,339 citation rows at 11,992 homes.
F656, the comprehensive care plan
F656 is the tag for 42 CFR 483.21(b). The facility must develop and implement a comprehensive person-centered care plan for each resident, consistent with resident rights, with measurable objectives and timeframes to meet the medical, nursing, and mental and psychosocial needs identified in the comprehensive assessment. The plan has to describe the services that will be furnished, and the services that would otherwise be required but are not provided because the resident refused them. Appendix PP tells surveyors that the plan is how the home turns the assessment into care. A citation here often means the plan was missing, late, or written in a way that staff could not follow, or that the care actually given did not match the plan. In this file, the description CMS uses most often for F656 is “Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured.” The code appears on 14,656 citation rows at 8,407 homes.
Frequency in the national file is a fact about surveyors' work in this release. It is not a judgment about a particular home. When the same code shows up on a record you are reading, the glossary page is the short definition, and the regulation linked above is the rule.
How a citation appears on a facility page
Open a home from the state list. Facility pages follow the path /nursing-homes/[state]/[city]/[slug]: the state postal abbreviation, the city, and the home. Citations are grouped by survey date. Each row shows the tag, linked to the glossary, the description CMS printed, the scope and severity letter in a short phrase, and the correction status. Under the description, the page marks a complaint survey, a standard survey, an infection-control survey, the inspection cycle, and whether the citation is under informal dispute resolution or independent informal dispute resolution.
The Health Deficiencies file includes rows that do not all enter the star rating. The data dictionary says the file keeps citations under dispute and citations from the third standard-survey cycle. The facility page says the same thing in plain language above the list: some citations are displayed and are not used in the health inspection rating. A public row is still a public finding. The star simply may not include it yet, or may never include that older cycle.
Compare puts up to four homes side by side and shows the cycle 1 health-deficiency count from the Provider Information file. That count is a total. The tags and the letters are on the facility page. If you are choosing between homes, open the citations. The guide to choosing a home walks through how to take those rows on a visit.
Complaint surveys and standard surveys
A standard health survey is the periodic inspection of federal requirements. Sections 1819(g)(2)(A) and 1919(g)(2)(A) of the Social Security Act require a standard survey no later than 15 months after the previous one, and a statewide average interval of no more than 12 months. CMS's nursing home certification page describes certification as at least a Life Safety Code survey, a standard health survey, and an emergency-preparedness survey. The deficiencies file marks a row "standard" when the deficiency was found on a standard inspection.
A complaint survey is a different visit. 42 CFR 488.332 requires the state survey agency to investigate complaints of violations of federal participation requirements. The data dictionary marks a row as a complaint deficiency when the deficiency was found on a complaint inspection. A complaint row means surveyors cited the home on that kind of survey. It does not list every complaint a family filed, and it does not include complaints the agency investigated without citing a tag. The September 2026 users' guide also counts complaint deficiencies, and focused infection-control deficiencies, in the health inspection score, with more weight on findings from the most recent 12 months.
The same file has a third flag for an infection-control inspection. A row can carry more than one flag when CMS recorded it that way. The dictionary says that if a deficiency is found on a standard inspection and a complaint inspection that occur together, the inspection cycle is the standard cycle. On the page, read the flags under the description rather than guessing the visit type from the date alone.
The state survey agency is the office that takes a complaint about care. CMS publishes contact information for state survey agencies. A later file may show a complaint citation if surveyors find noncompliance. State licensure findings are a separate record and do not always appear as an F-tag.
What to do with the tag in front of you
Write down the tag, the letter, the survey date, and the correction status. Ask the director of nursing what happened on that date and what the home changed. Ask to see the posted survey results. Federal rules require homes to make recent inspection results available, which is why tag F577 exists. If the letter is J, K, or L, ask whether anyone was hurt and whether the immediate-jeopardy finding has been lifted. If the same tag repeats across surveys, ask what broke in the system, not only what happened to one resident on one day.
A citation is not a fine. Fines and payment denials are enforcement actions in a different file, explained in the guide to fines and payment denials. A home with serious, repeated quality problems can also be selected for the Special Focus Facility program, explained in the Special Focus Facility guide. The tag tells you which rule was cited. The letter tells you how CMS graded the harm. The survey type tells you whether the finding came from the periodic inspection or from a complaint investigation.
Sources
- 42 CFR Part 483, including sections 483.5, 483.12, 483.21, 483.25, and 483.80.
- State Operations Manual, Appendix PP, surveyor guidance for F600, F656, F689, and F880.
- September 2026 Technical Users' Guide, Table 1, scope and severity points, and complaint and infection-control surveys.
- Provider Data Catalog, Health Deficiencies and the Nursing Home Data Dictionary.
- Social Security Act section 1819(g) and section 1919(g), survey frequency.
- 42 CFR 488.332, investigation of complaints.
- CMS nursing home certification and compliance and state survey agency contacts.
- CMS Provider Data Catalog, nursing homes, processing date September 1, 2026.